The Wisdom to Know the Difference
by Mousme
Summary: #12 in the Fusion 'verse. Sam gets strep throat and somehow it's Dean who ends up on the doctor's exam table.


Title: **The Wisdom to Know the Difference**

Summary: Part of the **Fusion** 'verse. Sam gets strep throat and somehow it's Dean who ends up on the doctor's exam table.

Characters: Sam, Dean, OC

Rating: PG-13

Wordcount: 4,754

Disclaimer: I stood really close to Jim Beaver this one time at L.A. Con. Does that count?

Warnings: Angst, the usual level of swearing

Neurotic Author's Note #1: So **de_nugis** expressed a desire for me to write another Fusion prequel in which Dean does some much-needed feeding up of Sam. That's what this started out as and then as is the wont of this freaking 'verse, it turned into something else.

Neurotic Author's Note #2: This is another prequel to Fusion, but again you don't really have to read the other stories in the 'verse to understand what's going on. It's set after bThe Gate is Straight, Deep and Wide/b.

Neurotic Author's Note #3: Unbeta'd, as usual.

* * *

Sam isn't sleeping. Dean can hear him breathing in the dark, just a little too quickly, over in the next bed. And, of course, if Sam isn't sleeping then Dean isn't sleeping.

Then again, he can't really blame Sam for the fact that he's an insomniac, not if he doesn't want to be a complete hypocrite about it all. Sleep hasn't been Dean's ally for years and even though the nightmares have tapered off a little –enough to let him get a few hours a night anyway– recently it's his goddamned knee that's been keeping him awake. Nothing's been working lately, not even the painkillers Lisa's GP prescribed to him when he wrenched it really badly a few months back. He probably tore his ACL, but he hadn't been willing to go the whole x-ray/MRI route back then. If he's honest with himself, he knows that the knee never really recovered from that last accident, that it's been hurting on and off ever since then, increasingly more 'on' than 'off,' a constant dull, throbbing ache, and that there are times when the pain is fucking excruciating. Right now it's not at levels that might make him seriously contemplate amputation as a viable option, but he can tell it's not going to be a good time unless he can get to the first aid kit in the next few minutes.

Dean pushes himself gingerly to his feet, winces when the soles of his feet come into contact with the threadbare carpeting of the tiny motel suite he managed to rent for them for the time being so they would be able to stay in whenever necessary. Sam... well, it's hard to pinpoint a single problem, but it all essentially boils down to the fact that Sam isn't coping well with being back topside. He spends a lot of time curled up on himself, staring at nothing, arms wrapped around his knees. Most of the time he barely talks, can't string together more than a couple of sentences before what he's saying becomes all but incoherent.

Dean knows what he's talking about, at least. He may not have been in the deepest recesses of hell when he was there, but he was deep enough, and it makes his stomach roil every time Sam loses track of reality and asks which level they're on. He remembers the levels, each and every one, remembers with all too much clarity exactly what went on there. Sam's arms are covered with thick keloid scars, raised and pink and angry-looking, some of the lacerations still scabbed over. The scars start at his hands and twine all the way up to his shoulders like malevolent vines. Dean recognized the pattern right off, stumbled into the bathroom to throw up, kept dry-heaving long after his stomach was empty while Sam crouched next to him, rubbing his back.

It's official, he thinks as he gets up and limps toward the bathroom, his knee is killing him. He catches himself against the wall and leans on it heavily as he walks, trying to take some of the pressure off. He sighs, braces himself against the sink in the bathroom while he dry-swallows two painkillers, and prays really hard that he's not going to end up on crutches. He sneaks a cigarette while he's in there, feeling almost as furtive as when he was first living with Lisa and Ben and had them both harping at him to quit. He can hear Sam still shifting restlessly in his bed and trying to be unobtrusive about it, almost forgets about his knee in his hurry to get back to his brother, stubbing out the cigarette on the side of the sink and promising himself he'll deal with it later. He perches on the edge of Sam's bed, tries not to take it personally when Sam flinches the first time he touches his arm.

"You okay, Sammy?"

Sam turns to face him, runs a hand down his arm. Dean submits to it patiently enough –Sam is always doing shit like this lately, reaching out and touching him, as though reassuring himself that Dean is real, isn't just a figment of his imagination. Not that Dean can blame him for not quite trusting any of it to be what it seems. Hell isn't just about the physical torture, after all. Dean isn't really used to the whole touchy-feely thing, and on top of that there are plenty of days when Sam can barely stand to have his own shirt on, let alone be touched, but Dean is nothing if not adaptable. So he lets Sam paw at him a little bit, even reciprocates by smoothing the hair away from his face and is startled when his hand comes away coated in sweat, heat coming off his little brother in waves.

"Jesus, you're burning up. Why didn't you say anything?" Dean switches on the lamp to illuminate the flush on Sam's cheeks, the unnatural brightness of his eyes. "Sam? How long've you been sick?"

Sam shrugs, still trailing his fingers along Dean's arm. "I don't feel any different," he says, voice cracking.

Dean scrubs at his face with his hand. This is just fucking great. "You can't tell you're sick?" He doesn't expect an answer and so isn't disappointed when he doesn't get one. "Okay, hang tight, I'm going to get you water and some ibuprofen, see if we can't get that fever down. Your sound like shit –your throat hurt?"

"Can't tell. Maybe?"

The painkillers haven't kicked in yet which makes getting to the bathroom and back a bit of an ordeal, but he makes it all the way, eases himself back onto the bed and makes Sam take the pills and swallow the entire glass of water, holding it to his lips and trying not to feel like too much of an asshole for enjoying the feeling of Sam's fingers wrapping themselves over his hand. Sam doesn't let go after, which kind of surprises him.

"Don't go..."

"You want me to stay? It's three in the morning, dude. You should try to get some sleep, and I'm way too old for slumber parties."

Sam's too far gone to even make a bitchface at the joke. "Sorry."

Dean's stomach clenches unpleasantly. It's been a damned long time since they've been together –over a year for him, a hundred times that for Sam if he's done the math right, and who even knows what the math means when you're in hell? – and they've lost even the uneasy truce they'd reached before, no matter how happy they are to be back together again. Dean doesn't know how to deal with Sam like this, and Sam seems determined to apologize for his entire existence, which isn't exactly helping matters. So he stretches out carefully alongside Sam, nudges him with a hip.

"Not what I meant, Sammy."

Almost immediately he finds himself wrapped in an overheated hug and wonders just when Sam started wanting to be this close to him again, like when he was still a chubby toddler. Then again, maybe it's not surprising that, after a century in the Cage with no one but Lucifer for company, his little brother would be craving a little human contact, not surprising that his little brother has somehow morphed into a giant octopus. Or maybe it's a squid, he can't really remember what creature it was that tried to snack on Captain Nemo in that movie. It had a beak, so maybe it was a squid, unless octopuses have beaks too –it's not like Dean knows anything about marine life. Is it octopuses?

"Sam, what's the plural of octopus?"

"Not funny," Sam tugs him closer.

"No, I'm serious, I can't think of it and it's going to drive me nuts."

"Octopuses, but it's kind of a controversial subject," Sam clears his throat, and Dean feels a little guilty at keeping him awake.

"You're kidding me."

"Uh-uh. Some people think it should be 'octopi,' but that's if you're using the Latin pluralization, which is inaccurate because the word is of Greek derivation. So that makes the plural 'octopodes.' Except that's stupid-sounding. And anyway, when you adopt a word into the English language it automatically takes on the characteristics of the new language, which means you can use the standard plural."

He reaches over to ruffle Sam's hair. "You're such a geek."

Sam snorts softly. "You're the one worrying about grammar at three in the morning."

He doesn't have a good answer to that, but Sam's breathing is already evening out, and it all doesn't seem quite as important anymore. He settles as comfortably as possible on the bed, eventually falls asleep to the sound of his little brother breathing beside him.

Sam is still sick in the morning, not that it comes as much of a surprise. He only reluctantly lets himself be pried away from Dean, sits on the bed with his knees drawn up to his chest, one cheek resting on his hands while Dean tries to figure out something that might be appealing for breakfast.

"Your knee's worse," Sam's voice is giving out.

"Lecture me about my health when it doesn't sound like someone's taken a cheese grater to your vocal cords," Dean says a little shortly, mostly because he's been trying not to think about how much his damned leg hurts today. "We should take you to a clinic, see what's up with that fever. I don't know about you, but I'm betting it's strep. Sam?"

Sam's look has gone vacant. Not quite empty but not quite there, either, shivering a little. Dean just pours boiling water over the contents of a packet of instant oatmeal, stirs it until it all combines into a vaguely unappealing slop, and sits on the bed. Sam's pretty pliant when he's like this, docile for the most part, but he just stares at the bowl like he's never seen anything like it in his entire life. So Dean just shrugs, dips the spoon into the oatmeal and holds it up.

"Just like old times, huh?" he jokes weakly, nudges and prods until his brother manages about half of the food. "Come on, you're already losing a ton of weight –and that's barely an exaggeration, given how goddamned giant you've become. Have another bite, Sammy. I won't insult us both by offering to make airplane noises."

Sam pulls away, looking around anxiously, rubbing the back of his wrist with his thumb. "What level is this?"

Dean puts the bowl down. "There aren't any levels here, Sam. You're out of there now, you're safe, remember?"

Sam nods jerkily. "I was looking for Dean."

He has never wanted a cigarette more in his entire life, worse even than when Dad died. "I know you were, but I'm right here now. You don't have to look anymore."

He should take Sam to Bobby's, he thinks distractedly, fingers already itching to open up his last pack of smokes. The oatmeal is forgotten, half-eaten and laid to the side. Bobby already knows Sam is back, already knows at least a little bit about how he didn't come back in as nearly good shape as Dean –mostly because from what Dean has been able to piece together it sounds like Sam dragged himself out of hell rather than getting ripped out of there by angelic intervention. Sure, having a handprint permanently etched on his shoulder is a pain in the ass to explain away, but it beats the alternative, even if it serves as a permanent reminder of just how long it's been since he last talked to Cas.

Fuck it. He reaches over to where his jacket is slung over the bed, ignoring the flare of pain in his knee, snakes out his pack of cigarettes from the pocket with the tips of his fingers. He flips open the top, pulls one out, lights it with a practised flick of his Zippo. Sam levels a look at him that he can't decipher, but says nothing as he takes a well-earned drag off the filter end and exhales slowly through his nose.

"So what do you feel like eating? Half a bowl of instant oatmeal isn't going to cut it. I got fruit. You think you could manage a banana? Good source of potassium and all that. There's even a crappy blender, so I could make you, like a smoothie or something. You like that sort of healthy crap." Sam doesn't answer, and he sighs. "Yeah, okay. I'm going to make you a smoothie. I got this protein powder stuff, but I bet you won't even taste it if I add enough bananas."

Sam just puts a hand on his good leg, fingers scraping at his jeans. He does this a lot, reassuring himself that Dean's real, that he's not about to dissolve and let Sam plunge back into his own personal hell.

"I'm still here, Sam."

"It's too bright, I can't see," Sam mumbles, shaking his head. It doesn't make any sense, but that's par for the course these days.

"Right. So I'm going to make it for you anyway, and you can give it a try."

Dean starts to slide off the bed, but he must make some sort of wrong move because the next thing he knows pain is lancing through his leg like a fucking bolt of lightning and practically folding him in half. He definitely doesn't whimper –Dean Winchester does not whimper under any circumstances– but tears of pain prick at his eyes as he grabs at his knee with both hands, trying to find enough breath with which to swear. Sam still has his hand on Dean's good leg, and he seems to figure out that something is wrong even through his own confusion, because he tightens his hold just a fraction. It shouldn't help, but somehow it does, a little bit.

"Dean..."

He doesn't know if he can breathe, let alone talk. "Just... gimme a sec, Sammy."

Sam's other hand creeps hesitantly toward his back, stops near his shoulder. "Dean," he says again, and it looks like he's groping for words as much as anything else. "Can you take me to a clinic?"

He swallows hard, forces himself to breathe through the pain. If Sam wants a doctor, then he can do that, no problem. "Sure."

To his surprise, Sam slides a hand under his elbow when he gets up, and it's a damned good thing, too, because Dean's suddenly not sure he can stand up on his own. "I don't... I can't drive us," Sam says quietly. "You okay?"

He twists a little bit, testing his weight on his leg, pats Sam's chest. "'Course I'm okay."

It's quite frankly a miracle that he manages to get them to a clinic. His leg is screaming in pain the whole time and by the time they get there Sam has to pull him out of the driver's seat by his armpits. It's all Dean can do not to scream in frustration (and maybe a little just from the pain), because this is the last thing he should be imposing on Sam, but there's absolutely nothing he can do about it. Not surprisingly, the people in the clinic assume that he's the one there for treatment, rather than Sam, who's not doing his best impression of a crippled eighty-year-old. He tries to wave them off, but Sam ducks his head, hangs onto his arm even tighter, whispers in his ear.

"I don't want to go in alone. Come with me and let them look?"

He sighs. It's stupid, and maybe they'll give him something to take the edge off anyway. "Sure. You hang onto me, Sammy," he says, just as though Sam's the one who's going to keel over if he lets go, rather than the other way around.

It's a little surreal. Sam perches in a chair in the corner of the little exam room, hugging his arms to himself, while the doctor motions Dean to the exam table. He hoists himself up by his arms, trying to keep the weight off his leg, gingerly pulls off his jeans at the doctor's request. He grimaces at his knee, which has swelled up since he last checked it, then hisses as the doctor very gently begins to probe at it.

"So what's the story here?" the doctor asks. He doesn't seem old enough to be a doctor, Dean thinks, barely out of diapers. Or maybe about Sam's age. Then again, they're in an urgent care clinic in a tiny town, so maybe it's not all that surprising that he's got Doogie Howser for a doctor.

"I dunno. I kind of wrenched it a few months back and it hasn't really been getting better."

Okay, maybe that's a bit of a lie. Dean's screwed up that knee so many times now he's sort of lost count, but the doctor doesn't need to know that. The doctor nods, straightens out his leg, and Dean can't bite back a grunt of pain as something grinds unpleasantly in his knee.

"Okay, describe the pain to me. What do you feel when you move the joint?"

"I don't know, it just hurts."

"Right," the doctor gives him a wry smile. "Tough guy. I can work with that. Is the pain sharp or dull?"

Dean glances at Sam, but it looks like his brother's checked out for the moment, rubbing the back of his hand with his thumb, hair falling into his face. "Uh, it sort of depends on if I'm moving or no –ow!" he yelps as the doctor manipulates his knee into a particularly painful position.

"Sorry. So if I read between the lines, you're telling me it hurts all the time. How long has that been the case?"

Dean shrugs a little sheepishly. "I guess. It's been getting worse the past few weeks. It, uh," he clenches his teeth, "it kind of feels like it's grating or something when I bend it, but mostly it just sort of aches all the time. And, you know, today it hurts like a son of a bitch."

"Uh-huh," the doctor has moved onto his good leg, bending and unbending the knee with a thoughtful look on his face. "It feels to me like you've got a fair bit of stiffness there. You have trouble bending it at all, outside of how much it hurts? And please don't lie, this isn't a test," he smiles to take the sting out of his words, making Dean feel like a total ass.

"Uh, yeah. It doesn't exactly bend all the way anymore. But it hasn't done that for a while."

"And a few months ago was the first time you injured it?"

Dean shrugs. "Not exactly. I kind of have a rough job."

"What sort of injury are we talking about? Since I don't have your medical files here, you're going to have to tell me."

He grimaces. "I don't know. I mean, half the time I just kind of strapped it up and walked it off, you know? Mostly sprains and whatever, but one time I messed up my ACL and another time I sort of maybe dislocated it. A little bit."

That whole situation with the dislocation had really sucked. A clear-cut poltergeist case they'd taken on in order to take their minds off of Lucifer and the apocalypse and the whole nine yards had gone south in a hurry, ending up with Dean at the bottom of a staircase with his knee facing in a direction it really wasn't ever meant to face. Cas had had to hold him down while Sam popped his kneecap back into place and wrapped it to within an inch of his life. He'd passed out from the pain and even though he'd refused a hospital afteward he'd been pretty much been confined to his bed for well over a week and had limped pathetically for weeks after that. Stupid poltergeist.

The doctor snorts a little bit, because apparently his bedside manner sucks. "I don't think I even want to know what your 'job' consists of."

"You really don't," Dean agrees.

There are more questions after that, some of which Dean doesn't even understand the point of asking. At one point he gets fed up and tries to deflect some of the attention onto Sam, who's been sick since last night too after all, but the doctor quashes that right off the bat.

"I'm going to send you to x-ray and I'll take a look at your brother while you're doing that."

Dean shakes his head. "No. I have to stay with him," he insists, looking over at where Sam is still hunched in his chair, hands rubbing together anxiously. "He's, uh, having kind of a hard time."

The doctor purses his lips. "You're going to be a handful, aren't you?" He steps over to Sam, though Dean is pleased to note that he doesn't try to touch him or get into his personal space. "It's Sam, right? I have to send your brother to get his knee x-rayed. Is it okay with you if I examine you while he's gone?"

Sam blinks a little dazedly, his gaze focussed on something Dean can't see. "I'm not... uh. Dean? Is it okay?"

If he's honest with himself, Dean isn't altogether keen on being away from Sam either, but Sam needs to get looked at too and the sooner they're out of this place the better he's going to feel about it all. "Sure it's okay. I won't be far, and this guy is just going to check you out, see what's up with that fever. Anything happens, you just tell them to come get me. I won't be far," he repeats, "promise."

"What do you say, Sam?" the doctor prompts, and Sam nods tightly.

About fifteen minutes later, Dean decides that he really, really hates not knowing where Sam is at all times. He's been poked and prodded and put in really uncomfortable positions and forced to wear a really heavy lead vest, but mostly he hasn't heard anything about what's happening to Sam and the thought makes his chest hurt. They're insisting he use a wheelchair, too, just to add insult to injury, and they only reluctantly take him back to the exam room after he spends an extra five minutes insisting on it. The doctor is waiting for him outside by his desk, his expression grim as he pulls up a chair so they can talk face to face.

"What's wrong?" Dean has to force himself not to grip the arms of his wheelchair. "I thought Sam had strep."

"It looks that way, but that's not what worries me. Is your brother being followed by a mental health professional?"

"No. No, he just... he just got back. We haven't seen anyone. Why? What's wrong?" Dean tries to ignore the cold, sick feeling in the pit of his stomach at the thought that this guy's found something else wrong with Sam. He won't be able to tell this guy that Sam just climbed his way out of hell, which totally explains why he's acting a little spacey.

The doctor gives him a speculative look. "You mean he was in the armed forces?"

He shrugs. "Sort of. Nothing exactly official." It's not a lie, he tells himself.

"Another part of that job I don't want to know about?" comes the question, tinged with something that sounds disapproving. Dean glares. Judgmental fuck.

"Something like that."

"Right, well. There are some things I can fix. There's about a ninety percent chance that your brother's got strep, so I'm prescribing antibiotics for that. As for the rest, he needs more intensive treatment than he can get in an urgent care clinic. You do realize that, right?"

Dean scowls harder, but the doctor doesn't back down. "Look, I don't know anything about either of you, but I can tell human suffering when I see it and that man in there is suffering." He points to the door behind him. "You want him to keep suffering, then you keep on like you've been doing, but let me tell you, if that's your plan, then I'm going to make damned well sure he doesn't leave this clinic."

"Sam isn't a threat," Dean growls.

"Yeah, yeah, I get it, you're the threat," the doctor rolls his eyes, and Dean feels kind of stupid. He's never been in the habit of hurting humans, after all. Just monsters. "You want what's best for your brother? Get him some proper help. He needs therapy and medication and an in-patient program probably wouldn't be out of the question. You're lucky he's not violent, with that level of dissociation and psychosis."

"He's not psychotic."

"He's seeing things that aren't there," the doctor says flatly. "That all but rules out PTSD, but I'm not an expert and I can tell when I'm out of my depth. I'm going to go take a look at your x-rays and I'm pretty sure that I'm going to be referring you to a specialist too, before the day is out. Look, Dean," he leans forward, expression earnest, "I'm not trying to be an asshole, here. You came because you need help, and I'm giving you your best option."

Dean scrubs at his hair, exhaling slowly. "Yeah, I get it. I do."

"I'm going to go look at your x-rays. Why don't you go talk to your brother in the meantime?"

Dean forgoes the wheelchair when he goes to Sam, finding him sitting on the exam table, back to the wall, knees drawn up to his chest. He eases himself back up onto the table beside him. All the moving around has actually loosened his knee up some, which is a relief.

"So I was thinking," he starts, trying to keep his tone casual, conversational. "Maybe once the doc gives us those prescriptions we came for and whatever, you and me could go see Bobby. You know he'll want to see you, and definitely me too, me being his favourite and all," he nudges Sam's knee, but Sam has his head ducked down so that Dean can't see his expression. "There's a hospital there, which means we could get you checked out, make sure there's nothing... uh..." he swallows, "I mean, nothing that maybe medication or something couldn't help with. A bit. You know, take the edge off, but, uh, make it officially medically prescribed for once. And, uh, the doctor thinks maybe I'll have to see someone about my knee, too. A specialist."

He stutters to a halt. For a while there's only silence, until Sam nods slowly. Dean blows out a breath he didn't realize he was holding. "Okay, then. Let's wait to see what the doctor has to say."

Dean doesn't know why he was expecting good news. It's not like their family has ever been known for their good luck. He tries not to stare in disbelief at the x-ray of what used to be a fully-functioning knee, only half-listening to the explanation that basically seems to be boiling down to the fact that he's probably never going to walk normally again, even with the painkillers he's being prescribed as a 'short-term solution' to the problem. Sam sits quietly next to him, his presence solid and reassuring even if he doesn't appear to be tracking any of what's happening at all. Dean can't bring himself to feel guilty about being relieved that his brother's here with him, thinks he might actually prefer to shoot himself right here and now rather than face this on his own. Things are about to change, he realizes, more than they ever have before, including being resurrected and surviving the apocalypse –twice. He's not sure how he's going to deal with it all, if he's honest with himself. He's never really liked change.

He pulls out his cell phone with his free hand when the doctor leaves, the other arm around Sam's shoulders, his brother pressed up against his chest. Sam's fever is still climbing, he notes, figures he'll mention it to the doctor when he's finished with his call. Dean's gotten pretty adept at dialing one-handed over the years, yet another one of those skills that he kind of wishes he didn't need. He closes his eyes as he waits, listening to the quiet ringing until someone picks up on the other end.

"Hi, Bobby? It's me..."


End file.
